|Ottawa Citizen Online|
Sunday 25 October 1998
Oxygen therapy 'makes brain work better'
Florida MD comes to Ottawa to describe brain-damage treatmentMaria Bohuslawsky
The Ottawa Citizen
Richard Neubauer, a pioneer of hyperbaric oxygen therapy, will bring both good news and bad when he speaks to parents of children with cerebral palsy in Ottawa next week.
The good news is that he believes the controversial therapy can probably help children with brain damage. The bad news is that it takes 200 to 300 treatments -- far more than most parents can afford. And it doesn't help everybody.
"This is not a miracle. This is not a panacea," he stressed in a phone interview from his Ocean Hyperbaric Centre in Lauderdale-by-the-Sea, Florida.
His clinic opened in 1972 and is the largest and one of the first hyperbaric oxygen therapy (HOT) clinics in the United States.
Dr. Neubauer, a 74-year-old internist, will give a free public lecture on Wednesday at the Ottawa Hospital's Civic site auditorium, 1053 Carling Ave. from 7 to 10 p.m. He will discuss HOT for brain-damaged children.
Dr. Neubauer treats 40 patients a day for such diverse ailments as stroke, coma, multiple sclerosis, head injury, near hanging, near drowning and Lyme disease. They come from around the world, including Canada. He began to treat CP a year ago.
He notes that the disorder occurs in babies usually because of a lack of oxygen, through bleeding in the brain, a problem with the placenta or a cord wrapped around the neck.
"Hyperbaric oxygen rapidly straightens those problems out," he says. "It makes the brain work better. We jump-start the brain and we produce a better environment for these children to grow brain tissue."
Hyperbaric medicine uses oxygen inhaled at high air pressure in special chambers. Some people believe that it can promote healing in the brain by stimulating brain cells around damaged tissue and reducing swelling.
Dr. Neubauer has treated about 40 children with CP. So far, about 80 per cent have had "significant improvement" he says.
The other 20 per cent had little or no improvement or didn't get enough treatment.
He described a three-year-old boy who, as a baby, couldn't crawl, couldn't suck and was blind. After 40 to 60 treatments, "the kid began to crawl and suck. He's got glasses and he's all over the place."
The children were treated twice a day for one hour at a time. He recommends 200 to 300 treatments. On average, the children had 80 treatments at his clinic, at a cost of $200 U.S. per hour. Most returned for more treatments or continued at other centres.
Nine local children will travel to Vancouver next month to become the first patients of a new private hyperbaric clinic.They will pay $3,000 for 30 one-hour treatments.
Dr. Neubauer says that 30 visits is a start and can show whether a child will benefit from the treatment.
Hyperbaric Oxygenation Corp., the company opening the clinic, sponsored Dr. Neubauer's visit to Canada.
"Once people are informed, they can make the proper choices," says Claudine Nadeau, a Montreal mother whose four-year-old twins improved dramatically after 22 sessions in England last May. Mrs. Nadeau has been made a company director, and is helping to set up a clinic in Montreal. The company has also expressed interest in opening a clinic in Ottawa.
Because of Mrs. Nadeau's experience, doctors at McGill University started a pilot project last Monday. They will give 20 treatments to 25 children, aged four to seven.
Although there is a chamber at the General site of the Ottawa Hospital, doctors won't treat children with CP, and OHIP won't pay, because it has not been conclusively proven by scientific research.
The chamber is used to treat wounds, radiation burns from cancer treatment, flesh-eating disease, carbon-monoxide poisoning and decompression sickness in deep-sea divers. It has a six-month waiting list.
Yvette Serpellini, whose 17-month-old daughter Rebecca has CP, started a non-profit foundation last month to raise $300,000 for a second chamber in Ottawa.
Dr. Phil Hamilton, an anesthetist in charge of the chamber at the General, has promised to do a study on CP children if the foundation buys the chamber.
"I think there are enough unanswered questions that this needs to be studied with a proper clinical trial," said Dr. Hamilton.
He has read Dr. Neubauer's recent book Hyperbaric Oxygen Therapy, Avery Publishing Group.
The 189-page book says little about cerebral palsy specifically but focuses on stroke, multiple sclerosis, central nervous system disorders, wounds, burns, bone disorders, radiation burns, circulatory problems and AIDS.
"Dr. Neubauer's work contains a great number of interesting anecdotes and tales but there's nothing in there that's he's published recently that's scientific," says Dr. Hamilton. "We feel it's important that the work be done properly and there's a proper balance given."
Dr. Neubauer plans to treat about 100 CP children over the next five years to see the effect of oxygen therapy.
He said the long term effects will not be known for 10 years and he is still working on figuring out the right dose. He said it's not known yet if they will need repeat treatments to maintain the benefit.
"The earlier we get them, the better chance we have of their growing new brain tissue."
The clinic also uses physiotherapy, occupational therapy, speech therapy and herbs.
Dr. Neubauer says that he has many critics in the United States and he's been called a quack and a charlatan. But he said most doctors are just ignorant about hyperbaric oxygen.
He documents his cases by taking pictures of the brain with a SPECT (Single photon emission computerized tomography) scan to see if there's an improvement in blood flow after treatment. Clinic staff also videotape the children.
"The thing that saddens us about the entire project is that we're the last to be thought of," he says. "We should have been there at the time of delivery, when the cord was around the neck, when the placenta separated. There would be so much less disability."
There is a small risk of damage to ears, sinuses or lungs from the pressure or seizures from too much oxygen. As well, the chambers are highly flammable.
Dr. Neubauer acknowledges the treatment is costly and points to England as a good example of how patients have banded together.
The Multiple Sclerosis Society, a non profit organization, bought chambers for their members. Two years ago they began to offer use of the chambers to CP patients, after a study by English doctors found positive results for brain damaged patients. They charge about $20 a session and have been reporting good results.
Dr. Neubauer calls oxygen "God's gift to man."
"There's nothing else to try and this holds a great deal of promise."
Dr. Neubauer will also speak on Tuesday in Montreal at the Queen Elizabeth Hotel from 7 to 10 p.m.
Copyright 1999 The Ottawa Citizen